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Health Services Research | Developing Cardiovascular Screening Measures for Pregnant and Postpartum Women | Disseminating Cervical Cancer Screening Guidelines Through the DOTS-O Patient Education Tool | Refugee Reproductive Health Network (ReproNet)

Disseminating Cervical Cancer Screening Guidelines Through the DOTS-O Patient Education Tool

Disseminating Cervical Cancer Screening Guidelines Through the DOTS-O Patient Education Tool »

HPV and Cervical Cancer
Screening with cytology has paralleled large decreases in cervical cancer mortality in the United States. However, there have been issues both with over- and underscreening of young women.

Each year, more than 13,000 women are diagnosed with cervical cancer in the United States. Yet cervical cancer is one of the most preventable cancers today. In most cases cervical cancer can be prevented through early detection and treatment of abnormal cell changes that occur in the cervix years before cervical cancer develops.

We now know that these cell changes are caused by human papillomavirus, commonly known as HPV. The traditional test for early detection has been the Pap test. For women age 30 and over, an HPV test is also recommended. HPV tests can find any of the high-risk types of HPV that are commonly found in cervical cancer. Though usually harmless, some types of HPV cause cervical lesions that, over a period of time, can develop into cancer if untreated. The majority of women with an HPV infection will not develop cervical cancer, but regular screening is crucial.

Understanding Cervical Cancer Prevention

DOTS-O Tool
The “Decreasing Overtesting but On time (DOTS-O)” (DOTS-O) tool enables English and Spanish speaking women to make informed decisions about cervical cancer screening and to better communicate with their provider. The Understanding Cervical Cancer Screening Tool is available in English, Spanish, and audio for the visually impaired.

DOTS-O Tool Website

For Patients: More information is available in this Understanding Cervical Cancer Screening Tool in English, Spanish, and audio for the visually impaired. Select “Click Here” to participate in the educational activity.

cervical-cancer-screening

Para Pacientes: Hay más información disponible sobre a Entendiendo Cáncer del Cuello Uterino en inglés, español y audio para personas con discapacidad visual. Seleccione "Click Here" para participar en la actividad educativa.

For Providers: This educational tool can be used in your clinics at your site to help educate patients to prepare for their Pap tests, educate them on understanding their results, and the current guidelines regarding frequency of cervical cancer screening.

Cervical Cancer Education Materials

NCCC Cervical Cancer Screening: Pap and HPV Tests

New landing page at the NCCC website to post tool, complementary health education materials, and updates.

ASHA Sexual Health: HPV & Cervical Cancer
ASHA website page with additional details about HPV/Cervical Cancer and screenings, including link to tool and cervical cancer FAQs

Quiero Saber: VPH
Spanish language page at the Quiero Saber website with link to tool and additional educational information on HPV and Cervical Cancer.
Más información sobre el virus del papilloma humano y cáncer del cuello uterino en español.

DOTS-O Project Overview  »

In 2019, the Regents of the University of California, Irvine received funding from the Patient-Centered Outcomes Research Institute (PCORI). The grant: Disseminating Cervical Cancer Screening Guidelines Through the DOTS-O Patient Education Tool is used to develop an online patient education tool, “Decreasing Overtesting but On time (DOTS-O),” to educate patients on HPV and cervical cancer and to engage patient groups in dissemination research.

This study is a partnership between the University of California, Irvine (UCI), University of California, Los Angeles (UCLA), the National Cervical Cancer Coalition (NCCC), a patient advocacy program of the American Sexual Health Association (ASHA), and the California Primary Care Association (CPCA). The project team will disseminate an effective online patient education tool, “Decreasing Overtesting but On time (DOTS-O),” that enables English- and Spanish-speaking women to make informed decisions about cervical cancer screening and to better communicate with their provider.

Objectives

The study seeks to inform patients and providers on evidence-based HPV testing and cervical cytology guidelines and to engage patient groups in dissemination research. The project’s aims are to:

  1. Increase patient knowledge about HPV and cervical cancer screening guidelines as well as patient’s comfort and ability to communicate with the provider about cervical cancer screening and management of abnormal cytology.
  2. Increase provider adherence to cervical cancer screening guidelines and enhance skills for engaging patients in cancer screening and follow-up through the use of the DOTS-O tool.
  3. Facilitate patient engagement in cervical cancer dissemination research.

Preliminary Data:
Increase in Knowledge Of African Immigrant Women In Northern California On Cervical Cancer Screening.
Preceptor: Heike Thiel de Bocanegra, PHD, MPH
MPH Candidate: Innocent Ikechukwu Durugbo

Conclusion: DOTS-O education tool can enhance the African (Nigerian, Ghanaian, Kenyan) immigrant women’s knowledge and the of management cervical cytology results. The cervical screening centers should adopt this education tool which can help to reduce diseases and death associated with cervical cancer.

Conferences

Co-Investigator Team

This project will continue the partnership between the University of California, Irvine (UCI), University of California, Los Angeles (UCLA), the National Cervical Cancer Coalition (NCCC), a patient advocacy program of the American Sexual Health Association (ASHA), and the California Primary Care Association (CPCA). UCI and UCLA will oversee clinical content and conduct provider outreach. With CPCA, they will conduct national provider webinars. The subawardee ASHA/NCCC will promote DOTS-O through its online community and social media ambassador network to patient and their community.

Heike Thiel de Bocanegra, MPH, PhD, Program Lead
University of California, Irvine, Department of Obstetrics and Gynecology

Dr. Thiel de Bocanegra is an Associate Professor in the Department of Obstetrics and Gynecology at the University of California, Irvine, with 25+ experience in program evaluation and health service research. She was co-investigator of a clinic trial funded by the Patient Centered Outcomes Research Institute (PCORI) entitled “Randomized Trial to Increase Adherence to Cervical Cancer Screening Guidelines for Young Women.”

Jill Tseng, MD, Co-Investigator
University of California, Irvine, Department of Obstetrics and Gynecology
Dr. Jill Tseng is assistant professor at UCI , specialized in gynecologic oncology. She received her medical degree from University of Toledo College of Medicine, and completed her fellowship in gynecologic oncology at Memorial Sloan-Kettering Cancer Center.

Anna-Barbara Moscicki, MD, Co-Investigator
University of California, Los Angeles, Department of Pediatrics

Dr. Moscicki is a Pediatrician, Board Certified in Adolescent Medicine. She is the current Division Chief of Adolescent and Young Adult Medicine with clinical expertise in reproductive health caring for menstrual irregularities, sexual health, and sexually transmitted diseases. Her extensive research experience, includes a cluster clinic trial funded by the Patient Centered Outcomes Research Institute (PCORI) entitled “Randomized Trial to Increase Adherence to Cervical Cancer Screening Guidelines for Young Women.”

Fred Wyand, Co-Investigator
American Sexual Health Association (ASHA)

ASHA’s Director of Communications, Fred has been with ASHA since 1997 and has managed the HPV and cervical cancer prevention programs since 2003. Fred edits ASHA’s bimonthly HPV newsletter and works closely with our policy office in Washington, DC.

Hailey Maxwell, Research Personnel
University of California, Irvine, Department of Obstetrics and Gynecology, Department of Anesthesia and Perioperative Care
Hailey Maxwell is an Assistant Research Specialist in the Department of Obstetrics and Gynecology at the University of California, Irvine, with research experience in the MFM division. She is the main clinical research coordinator for the project.

Dissemination Advisory Group

A dissemination advisory group will meet semi-annually. NCCC’s social media ambassadors and NCCC chapter leaders will be involved throughout the project and provide their insights. CPCA will gather feedback from webinar provider attendees.

Lynn Barclay
American Sexual Health Association (ASHA)
President and Chief Executive Officer of American Sexual Health Association. Working with experts from around the country from academia, federal government, researchers as well as corporate America, Barclay has led ASHA in the development of the framework for sexual health. 

Erin Perry
California Primary Care Association (CPCA)
Erin Perry is a deputy Director of Education and Training at California Primary Care Association. She has lead the organization’s comprehensive training program, which includes an array of diverse in-person and webinar learning sessions to support community health center staff and leadership.

Christine Conageski, MD
University of Colorado, Department of Obstetrics and Gynecology; Board of Directors, ASCCP
Dr. Conageski specializes in lower genital tract diseases and currently runs the Vulvar Clinic and Complex Dysplasia Clinic at the University. She speaks nationally and internationally on HPV related conditions and vulvar disorders. In further commitment to the prevention and treatment of HPV-related dysplasias, she is trained in high resolution anoscopy and treats men and women for anal dyplasias.

Daryn Eikner, MS
National Family Planning & Reproductive Health Association (NFPRHA)
Daryn Eikner is the Vice President of Health Care Delivery at the National Family Planning & Reproductive Health Association.

Francesca M. Gany, MD, MS
Memorial Sloan Kettering Cancer Center (MSKCC)
Dr. Gany also serves as a director of the community-based participatory South Asian Health Initiative, now based at Memorial Sloan Kettering. She works to bridge immigrants, minority community members, and the medically underserved with the healthcare system, and to eliminate health disparities. Her groundbreaking work has led to improvements in health outcomes and to the development of long-term clinical, health policy, and programmatic changes.

Susan Rubin, MD, MPH
The Institute for Family Health, New York
Dr. Susan E. Rubin is the reproductive health research director at the Institute for Family Health and associate professor in the Department of Family Medicine and Community Health at the Icahn School of Medicine at Mount Sinai. She provides patient care as a family physician at the Institute’s Amsterdam Family Health Center.  She has conducted numerous health services studies focused on improving provision of full scope reproductive health care in primary care practices.

Ysabel Duron
The Latino Cancer Institute
Founder and former Chief Executive Officer of The Latino Cancer Institute. Duron is a member of the National Association of Hispanic Journalists Hall of Fame, develops community outreach and health education tools for low income communities, and media, marketing, and fundraising expertise for small agencies.

Alegra Woodard
The National Cervical Cancer Coalition
Alegra Woodard is passionate about helping others because she understands firsthand what it means to be diagnosed with a disease that kills more than 4,000 women in the U.S. each year, even though it is a preventable cancer. The majority of her efforts are focused toward providing support, raising awareness, and providing educational resources and other crucial information to survivors and their families. She is a Chapter Leader at the National Cervical Cancer Coalition, Northern Virginia Chapter.

Kalyn Guerrero
The National Cervical Cancer Coalition
Kalyn Guerrero is a survivor of cervical cancer and is committed to spreading awareness about cervical cancer and HPV prevention. She is a Chapter Leader at the National Cervical Cancer Coalition, Texas Chapter.